Tag: pubmed

Liver Int. 2025 Sep;45(9):e70259. doi: 10.1111/liv.70259.

ABSTRACT

BACKGROUND AND AIMS: A recanalisation-specific model for Budd-Chiari syndrome (BCS) is lacking. We aimed to develop a novel score for individual long-term outcome prediction and risk stratification.

METHODS: Overall, 834 BCS patients undergoing recanalisation (566 received percutaneous transluminal angioplasty alone, and 268 with routine stenting) from January 2010 to May 2019 were included from six Chinese centres. The model was developed using Cox multivariable regression, internally validated through a 1000-times bootstrapped method, and compared its performance with existing BCS prognostic models, like the Clichy score.

RESULTS: During the median follow-up period of 58.0 months, 44 patients were converted to transjugular intrahepatic portosystemic shunt (TIPS), none underwent orthotopic liver transplantation (OLT) and 75 died. The final BCS-Recanalisation score incorporated: variceal bleeding history, degree of ascites, albumin, creatinine, urea, white blood cell count and Ln (alkaline phosphatase). The score outperformed other available models with good discrimination (C-index: 0.74) and calibration in predicting TIPS-free survival in the whole cohort, internal validation and most subgroups. Moreover, patients were categorised as low-risk (BCS-Recanalisation score ≤ 2.0), intermediate-risk (2.0-2.6) and high-risk (> 2.6) groups using X-tile software, with a 5-year TIPS-free survival rate of 92.2% (95% CI: 89.5%-95.0%), 84.7% (95% CI: 80.0%-90.0%) and 67.8% (95% CI: 59.4%-77.5%), respectively (p < 0.001). Significant differences were observed in overall survival, stenting-TIPS-free survival and competing-risk adjusted outcomes (restenosis, symptom recurrence, TIPS conversion) across risk strata.

CONCLUSIONS: The BCS-Recanalisation score enables individualised outcome prediction and risk stratification in recanalisation-treated patients with BCS, showing promise for clinical application. Future external validation is required.

PMID:40751473 | DOI:10.1111/liv.70259

J Clin Hypertens (Greenwich). 2025 Aug;27(8):e70044. doi: 10.1111/jch.70044.

ABSTRACT

The protective effect of influenza vaccination on stroke risk has been inconclusive. In this study, we aimed to investigate the impact of influenza vaccination on the 1-year risk of stroke in individuals aged 60 years and older with COPD and hypertension or diabetes mellitus. We conducted a retrospective cohort study in four districts of Shanghai, China, from August 2017 to July 2019. Data were collected from various information systems related to chronic disease management, cardiovascular reporting, and immunizations. The incidence of stroke within 1 year was compared between vaccinated and unvaccinated chronic disease patients. Cox proportional hazards regression was used to calculate hazard ratios (HRs). Sensitivity analysis was performed using the Poisson regression model to examine the association between influenza vaccination and stroke incidence, and propensity score matching was employed to address confounding. We found that influenza vaccination was associated with a lower risk of stroke during the two influenza seasons, 2017-2018 (adjusted HR, 0.27; 95% CI, 0.10-0.73) and 2018-2019 (adjusted HR, 0.46; 95% CI, 0.21-1.02). The results from the Poisson regression model (RR, 0.26; 95% CI, 0.10-0.70) were consistent with those obtained from the Cox model analysis. The reduction in stroke risk associated with influenza vaccination ranged from 54% to 73%. Our findings suggest that influenza vaccination is associated with a lower 1-year risk of stroke in individuals with chronic illnesses, compared to those who are not vaccinated.

PMID:40751465 | DOI:10.1111/jch.70044

J Clin Hypertens (Greenwich). 2025 Aug;27(8):e70108. doi: 10.1111/jch.70108.

ABSTRACT

Understanding class-specific antihypertensive adherence is crucial for optimizing hypertension management. This retrospective cohort study analyzed adherence to antihypertensive medication among commercially insured adults (18-64 years) from 2018 to 2023 using Merative MarketScan data. Adherence was defined as the proportion of days covered (PDC) ≥ 80%. Among 2 770 855 hypertensive patients with single-pill therapy, the majority were older (43% aged 55-64 years) and predominantly male (53%). The South had the highest prevalence of hypertension (53%). Overall adherence improved significantly from 56.61% in 2018-2019 to 75.55% in 2022-2023 across all medication classes. Patients receiving angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEi/ARB) combination therapies had the highest adherence rate (79.18%), while diuretics (67.58%) and “Other Drugs” (57.38%) had the lowest in 2022-2023. Logistic regression showed that younger patients (18-34 years) were significantly less adherent than older adults (OR = 0.434, 95% CI: 0.420-0.448). Males were more likely to adhere than females (OR = 1.142, 95% CI: 1.129-1.156). Regional variations were notable, with patients in the Northeast exhibiting 15% higher adherence than those in the West. Insurance types also influenced adherence, with managed care plan enrollees showing better adherence than those in fee-for-service plans (OR = 1.165, 95% CI: 1.151-1.179). Surprisingly, prescription refill monitoring reduced adherence, decreasing odds by 52% (OR = 0.482, 95% CI: 0.470-0.490). Monotherapy and combination therapy users differed significantly across all demographics (p < 0.0001). Higher comorbidity burden correlated with lower adherence, with diabetes being most prevalent among users of diuretics (12.88%), beta-blockers (12.8%), and other antihypertensives (26.01%). These findings highlight the multifaceted barriers to antihypertensive adherence and emphasize the need for targeted interventions that address medication-specific and patient-specific factors.

PMID:40751459 | DOI:10.1111/jch.70108

Dev Med Child Neurol. 2025 Aug 2. doi: 10.1111/dmcn.16415. Online ahead of print.

ABSTRACT

AIM: To investigate the validity of Selective Control Assessment of the Lower Extremity for Infants and Toddlers (Mini-SCALE), an adaptation of Selective Control Assessment of the Lower Extremity (SCALE), in young children aged from 3 months to less than 4 years.

METHOD: Mini-SCALE was modified from SCALE and reviewed by 16 experienced clinicians to establish content validity. For convergent validity, Mini-SCALE was compared to the Developmental Assessment of Young Children, Second Edition, Gross Motor subdomain (DAYC-2 GM) for 50 participants (aged 4-46 months, 29 males) with cerebral palsy (CP) (n = 20), at risk for CP (n = 9), and typically developing participants (n = 21) using a prospective cross-sectional design. For known-group validity, the scores of children with or at risk for CP were compared to typically developing children using the Welch’s two-sample t-test.

RESULTS: Content validity was strong with 96.6% (range = 75%-100%) expert agreement on 54 statements about content, administration, and grading. Convergent validity was strong between Mini-SCALE and the DAYC-2 GM (Spearman’s rank correlation coefficient, r_s = 0.80; p < 0.001). Mini-SCALE discriminated between children with or at risk for CP and typically developing children (p < 0.001).

INTERPRETATION: Mini-SCALE is a valid measure of selective motor control for young children with or at risk for CP.

PMID:40751442 | DOI:10.1111/dmcn.16415

Clin Exp Dermatol. 2025 Aug 2:llaf370. doi: 10.1093/ced/llaf370. Online ahead of print.

ABSTRACT

Objective Structured Clinical Examinations (OSCEs) using real dermatology patients are challenging to standardise due to condition variability and urgent removal of cancerous lesions. Simulated patients alongside photographs offer standardisation but lack authenticity and disrupt consultation flow. Instructional Dermatology Surface Models (IDSMs) offer a realistic alternative, replicating dermatoses as temporary 3D transfers. This project evaluated medical student experiences using an IDSM depicting malignant melanoma within a OSCE involving 263 students. Post-exam, 80 students completed an online questionnaire assessing realism, utility, and communication. Data was analysed using descriptive statistics and sentiment analysis. Students found the IDSM realistic and beneficial for enhancing consultation skills. Positive sentiments dominated; the net sentiment ratio was 5.3%, and ‘realistic’ was the most common descriptor. 91% of students preferred IDSMs over photographs. Findings suggest IDSMs benefit dermatology examinations by better simulating clinical practice. The increased cost of IDSMs compared to photographs, is an important consideration for their use.

PMID:40751439 | DOI:10.1093/ced/llaf370

J Appl Toxicol. 2025 Aug 2. doi: 10.1002/jat.4872. Online ahead of print.

ABSTRACT

Smoking is a major public health concern worldwide. The toxic components of cigarettes, such as nicotine, can cause abuse, dependence, and tissue damage. This study aimed to evaluate the effects of exposure to cigarette smoke on the renal morphology of Wistar rats. For this purpose, 12 male rats were used, divided into two groups (n = 6): CT Group (control) and CG Group (cigarette). The CG Group was exposed to smoke from six cigarettes per day. After 12 weeks, the rats were euthanized, and the kidneys were collected, weighed, and processed histologically for renal tissue analysis. Although the increase in renal weight was not statistically significant (p = 0.479), the CG Group exhibited significantly reduced values for glomerular diameter, capsular area (p < 0.0001), subcapsular area (p = 0.0045), and glomerular tuft area (p = 0.0049) compared to the CT Group. These results indicate that cigarette smoke exposure induces morphological changes in renal structure, even in the absence of significant weight alteration.

PMID:40751407 | DOI:10.1002/jat.4872

Phytother Res. 2025 Aug 2. doi: 10.1002/ptr.70054. Online ahead of print.

ABSTRACT

Chronic diseases cause early death and financial strain worldwide. Cardio-metabolic health, crucial for preventing cardiovascular disease and type 2 diabetes, may benefit from bilberry’s antioxidant and anti-inflammatory properties. This meta-analysis reviews studies of bilberry’s impact on lipid profiles, glycemic indices, body composition, and inflammatory and oxidative factors. Inclusion criteria were randomized clinical trials assessing bilberry supplementation in adults for at least 1 week. A comprehensive review of literature was performed in PubMed, Web of Science, Scopus, and Google Scholar until July 21, 2024, without any time limitations. Mean changes and their SDs were used to calculate overall effect sizes, with the Hozo et al. method converting SEs, 95% CIs, and IQRs to SDs. A random-effects model accounted for between-study variations. Eleven RCTs, including 409 individuals, were incorporated into the present systematic review, and 8 were included in the meta-analysis. Combining five effect sizes from the five trials on long-term effects of bilberry administration compared with controls resulted in a non-significant decrease in FBG (WMD: -0.08 mmol/L, 95% CI: -0.22 to 0.07, p = 0.30). For HbA1c, the meta-analysis of three RCTs showed a marginally significant reduction (WMD: -1.63%, 95% CI: -3.36% to 0.11%, p = 0.06). The results of the meta-analysis on lipid profile showed a decreasing trend, although this reduction was not statistically significant for TC (WMD: -0.11 mmol/L, 95% CI: -0.30% to 0.08%, p = 0.27) or TG (WMD: -0.07 mmol/L, 95% CI: -0.32% to 0.19%, p = 0.62). However, a significant change in TG was reported in trials with a crossover design and RCTs with 4 weeks of intervention or less. Although HDL level did not show any significant change (WMD: -0.02 mmol/L, 95% CI: -0.10% to 0.07%, p = 0.70), the meta-analysis of five RCTs evaluating the long-term effects of bilberry supplementation revealed a significant change in LDL following bilberry supplementation (WMD: 0.07 mmol/L, 95% CI: 0.01%-0.14%, p = 0.01). Furthermore, no significant reduction was observed in SBP (WMD: -2.75 mmHg, 95% CI: -6.38% to 0.89%, p = 0.13) or DBP (WMD: -1.00 mmHg, 95% CI: -4.66% to 2.65%, p = 0.59) after bilberry supplementation. Finally, anthropometric indices including body weight (WMD: 0.04 Kg, 95% CI: -0.44% to 0.53%, p = 0.86) and inflammatory and oxidative stress markers including hs-CRP (WMD: -8.22 mg/L, 95% CI: -20.24% to 3.81%, p = 0.18), IL-6 (WMD: -7.19 pg/mL, 95% CI: -19.01% to 4.63%, p = 0.23), uric acid (WMD: -0.01 mmol/L, 95% CI: -0.03% to 0.01%, p = 0.36), and FRAP (WMD: -42.03 μmol/L, 95% CI: -100.54% to 16.48%, p = 0.16) showed no significant change after bilberry supplementation. Bilberry supplementation may have beneficial effects on HbA1c and TG, but not other cardio-metabolic indices. Therefore, long-term and high-quality trials are needed to confirm the promising effects of bilberries.

PMID:40751398 | DOI:10.1002/ptr.70054

J Homosex. 2025 Aug 2:1-22. doi: 10.1080/00918369.2025.2540367. Online ahead of print.

ABSTRACT

Bi+ men have disproportionately high rates of mental health, physical health and substance use concerns. According to minority stress theory, societal stigma adversely impacts health outcomes for LGBTQ+ individuals. This study focused on improving health outcomes for bi+ men, a group that has received little focus in the literature outside of focusing on sexual health. The current intervention aimed to help bi+ men process through previous biphobic experiences by exploring two interventions, psychoeducation and emotion focused writing, and evaluated their effectiveness in reducing the impact of biphobic events. To evaluate intervention effectiveness, we measured participants’ identity-related concerns, trauma/stressor symptoms, depression levels and gender role norms before and after completing one of the two interventions. Overall, the results suggest that both interventions may be helpful in reducing the impact of biphobic events and improving health outcomes for bi+ populations, with intervention differences in gender role conflict and internalized biphobia. These interventions could be a helpful supplement or alternative to individual therapy to process through biphobic experiences.

PMID:40751390 | DOI:10.1080/00918369.2025.2540367

Int J Dev Neurosci. 2025 Aug;85(5):e70034. doi: 10.1002/jdn.70034.

ABSTRACT

BACKGROUND AND OBJECTIVE: Autism spectrum disorder (ASD) is a complex neurological condition that impacts cognitive, social and behavioural abilities. Early and accurate diagnosis is crucial for effective intervention and treatment. Traditional diagnostic methods lack accuracy, efficient feature selection and computational efficiency. This study proposes an integrated approach that combines the electromagnetic interaction algorithm (EIA) for feature selection with the adaptive kernel attention network (AKAttNet) for classification, aiming to improve ASD detection performance across multiple datasets.

METHODS: The proposed methodology consists of two core components: (1) EIA, which optimises feature selection by identifying the most relevant attributes for ASD classification, and (2) AKAttNet, a deep learning model leveraging adaptive kernel attention mechanisms to enhance classification accuracy. The framework is evaluated using four publicly available ASD datasets. The classification performance of AKAttNet is compared against traditional machine learning methods, including logistic regression (LR), support vector machine (SVM) and random forest (RF), as well as competing deep learning models. Statistical evaluation includes precision, recall (sensitivity), specificity and overall accuracy metrics.

RESULTS: The proposed model outperforms conventional machine learning and deep learning approaches, demonstrating higher classification accuracy and robustness across multiple datasets. AKAttNet, combined with EIA-based feature selection, achieves an accuracy improvement ranging from 0.901 to 0.9827, Cohen’s kappa values between 0.7789 and 0.9685 and Jaccard similarity scores from 0.8041 to 0.9709 across four different datasets. Comparative analysis highlights the efficiency of the EIA algorithm in reducing feature dimensionality while maintaining high model performance. Additionally, the proposed method exhibits lower computational time and enhanced generalizability, making it a promising approach for ASD detection.

CONCLUSIONS: This study presents a practical ASD detection framework integrating EIA for feature selection with AKAttNet for classification. The results indicate that this hybrid approach enhances diagnostic accuracy while reducing computational overhead, making it a promising tool for early ASD diagnosis. The findings support the potential of deep learning and optimisation techniques in developing more efficient and reliable ASD screening systems. Future work can explore real-world clinical applications and further refinement of the feature selection process.

PMID:40751377 | DOI:10.1002/jdn.70034

Glob Chang Biol. 2025 Aug;31(8):e70373. doi: 10.1111/gcb.70373.

ABSTRACT

Enhanced rock weathering (EW) is gaining attention as a promising carbon dioxide removal strategy, primarily due to its potential to sequester inorganic carbon through mineral dissolution. However, the broader biogeochemical implications of EW, particularly its effects on soil organic carbon (SOC) dynamics, as well as the role played by agriculturally relevant biota such as plants and earthworms, remain poorly understood. In a 15-month mesocosm experiment with Zea mays, we investigated how EW with basalt influences soil CO₂ efflux (SCE; normalized for soil water content and temperature) and how this is modulated by plant and earthworm presence. Using δ¹³C-CO₂ isotope tracing based on the C₃-C₄ shift method, we partitioned normalized SCE into rhizosphere (root plus microbial respiration of rhizodeposits) and soil organic matter components. In the first growing season, basalt increased normalized SCE 2.8-fold in planted mesocosms relative to planted controls, due to elevated rhizosphere respiration. In contrast, during the second growing season, basalt significantly decreased normalized SCE 16.5-fold, but only in unplanted mesocosms. Mediation analysis revealed that basalt also indirectly influenced SCE via changes in soil water content, with the direction of this effect depending on plant presence and growing season. Basalt showed contrasting direct and indirect effects, highlighting the complexity of soil responses to silicate amendments, where multiple, sometimes opposing, processes operate simultaneously. Disentangling such effects is essential for understanding the impact of EW on soil carbon and for effective and reliable upscaling. Our findings suggest that SOM stabilization might occur after basalt application, decreasing SCE. Moreover, they demonstrate that both biotic and abiotic factors (e.g., vegetation, soil fauna, soil moisture) can modulate the impact of EW on SOC dynamics. To quantify the climate change mitigation effect of EW, research must move beyond inorganic carbon and explicitly integrate biotic and organic processes into EW assessments.

PMID:40751376 | DOI:10.1111/gcb.70373